FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 22789999 · Received August 12, 2025

Report

Report Number
3004753838-2025-220105
Event Type
Malfunction
Date Received
August 12, 2025
Date of Event
July 23, 2025
Report Date
September 22, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270003935
PMA / PMN Number
K213919
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-220105 AND 3004753838-2025-220105-01 WERE REPORTED IN ERROR. PLEASE DISREGARD INITIAL REPORTING OF THIS EVENT AS THIS EVENT HAS NOW BEEN DEEMED NOT REPORTABLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT MISSING SENSOR WIRE OCCURRED. THE WEARABLE WAS INSERTED INTO THE ABDOMEN, WHICH IS OFF-LABEL USAGE OF THE DEVICE, ON (B)(6) 2024. NO PRODUCT WAS PROVIDED FOR EVALUATION. THE ALLEGATION AND A PROBABLE CAUSE COULD NOT BE DETERMINED. NO INJURY OR MEDICAL INTERVENTION WAS REPORTED.

Description of Event or Problem · 0

SUBSEQUENT TO THE INITIAL MDR, A CORRECTION IS REQUIRED.

Description of Event or Problem · 0

AFTER SUBMISSION OF THE INITIAL MDR, PRODUCT WAS RECEIVED ON 8/27/2025 AND IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER CORPFT-140202.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1350491 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9500-161 1725154005 00386270003935

Patients

Seq Age Sex Outcome Treatment
1 8 YR Male TANDEM T SLIM PUMP